Guyon Canal Syndrome

January 15, 2025

A person wearing a light blue and white striped shirt holds their right wrist with their left hand. The image focuses on the hands and wrists, suggesting possible wrist pain or discomfort.

Our hands are essential for nearly every task we do, and when pain, numbness, or weakness affects our hands, it can disrupt our daily lives. One condition that can cause these symptoms is Guyon Canal Syndrome, a form of nerve compression that often goes unnoticed until it significantly impacts function. Orlin & Cohen’s occupational therapist, Benjamin Villari, is here to help you understand the causes, symptoms, and treatment options for this condition so that you can prevent any further complications and help restore hand strength and dexterity.

What is Guyon’s canal syndrome?

Guyon canal syndrome, also known as ulnar tunnel syndrome, is a condition where the ulnar nerve becomes compressed in the wrist. This compression often leads to discomfort, weakness, and difficulty performing tasks requiring hand use.

What is Guyon’s canal and the ulnar nerve?

The ulnar nerve is one of the hand’s key nerves, providing sensation to the ring and pinky fingers and controlling muscle movement in the palm and thumb. It travels from the neck, down the arm, and through the wrist, passing through Guyon’s canal, a narrow tunnel-like structure made of carpal bones, ligaments, and tendons.

Guyon’s canal protects the ulnar nerve, but its confined space makes it susceptible to pressure and injury, which can disrupt nerve function and cause symptoms.

What causes Guyon’s canal syndrome?

Guyon canal syndrome typically results from repetitive motions, such as heavy gripping or twisting of the wrist, which can irritate the structures in the canal. Other causes can include:

  • Injuries: Fractures or trauma to the wrist that lead to swelling and increased pressure.
  • Occupational or sports activities: Repetitive hand and wrist motions associated with cycling, weightlifting, or certain jobs.
  • Anatomical variations: Abnormalities in the canal’s structure that compress the ulnar nerve.

What are common symptoms of Guyon’s canal syndrome?

Symptoms can often vary depending on the severity of the compression but often begin with tingling or numbness in the ring and pinky fingers. Over time, symptoms can progress to include:

  • Burning sensations in the wrist or hand
  • Weakness in the palm or thumb muscles
  • Difficulty gripping or pinching objects
  • Inability to spread fingers apart or touch the thumb to other fingers

These symptoms can interfere with daily life and significantly impact quality of life, so early diagnosis and treatment are essential.

How is Guyon’s canal syndrome treated?

Conservative treatment

Nonsurgical treatment focuses on reducing inflammation, relieving nerve pressure, and maintaining hand strength. The most common approach is occupational therapy, where manual manipulation is used to alleviate compression and nerve gliding exercises to facilitate smooth nerve movement. Strength exercises also help stabilize the wrist and improve hand function.

In cases of severe inflammation, steroid injections may be used to reduce swelling and alleviate pressure on the ulnar nerve. These methods aim to restore normal nerve function and minimize symptoms without surgical intervention.

Operative treatment

For severe cases where conservative treatment isn’t effective, surgery could be necessary. The goal of surgical treatment is to release the structures compressing the nerve within the Guyon canal. Postsurgical rehabilitation will include occupational therapy to:

  • Reduce scar tissue and swelling
  • Restore wrist and hand movement
  • Rebuild strength and dexterity for daily tasks

Timely surgery and rehabilitation can provide significant symptom relief and improve hand functionality.

Guyon canal syndrome can significantly impact your ability to perform routine tasks. If you’re experiencing symptoms like numbness, tingling, or weakness, book an appointment with an Orlin & Cohen hand specialist to ensure an accurate diagnosis and effective treatment. With the proper care, you can regain control of your hand function and feel better, faster.